I am not alive

by Suvarunika Thirumaran

I do not exist anymore.

I am dead.

My body parts are gone.

A rare syndrome that causes people to believe that they are no longer alive and that their existence has ended. 

Cotard’s Syndrome, first described as Le délire des negations or ‘The Delirium of Negation’ by a French neurologist Jules Cotard, sometimes called walking corpse syndrome, is where people believe that they have died. This could be a result of: 

• Dementia

• Epilepsy

• Stroke

• Encephalopathy

• Multiple sclerosis

Self-starvation, denial of existence and movement, anti-social behaviour and neglection of self are all symptoms of Cotard’s syndrome. All these symptoms are dangerous for a individual who experiences it and could lead to their actual death, especially via starvation, suicide or self-harm. 

This delusion was first reported in the 1700s of an elderly woman who became paralysed whilst preparing a meal and once her ability to speak had returned, she demanded her family and friends to treat her like she was dead, going as far as to placing herself into a coffin and dressing up for her own funeral.

It is thought that this condition typically exists in people with:

• Depression

• Schizophrenia 

• Other mental illness associated with memory loss

What is the treatment? CBT (Cognitive Behavioural Therapy) or psychotherapy, which is a type of talk therapy, are the main forms of treatment. These are undergone along with prescribed medication such as antipsychotics, anti-anxiety drugs and antidepressants.

As the syndrome is really rare, the statistics, evidence and research into it are also limited. It is reported to affect all ages, typically more prominent in elderly females than males. Over time, it has been theorised that there can be different periods of the syndrome, split into three stages of germination, blooming and chronic stage. The germination stage consists of a development of fear or anxiety of one’s health (hypochondriasis) where people have been recorded to start doubting their health and determine they are ill or unwell despite evidence that they are healthy. Moving onto the blooming stage, it is exactly as the name suggests, where these delusions strengthen and are firmly believed. Finally, the chronic stage is where persistent changes in mood is recorded. 

If psychotherapy does not work or if symptoms reoccur, the final treatment used is ECT or Electroconvulsive Therapy, which is a procedure that is often used in patients with severe depression, anxiety or bipolar disorder. It is a procedure that is estimated to be very helpful at about an 85% success rate and is a final resort as it involves an electrical stimulation to the brain with possible short/long term memory loss being a side effect. However, there is always a possibility of Cotard’s Syndrome returning even after all the treatments. Hopefully an increase in medical research into the syndrome will lead us to a bigger breakthrough as to what it is, why exactly it occurs and how to get rid of it fully.